医院前医生的临床经验与现场出院之间的关联 - 追溯队列研究
Romain Betend1, Laurent Suppan1, Michele Chan1
1Division of Emergency, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine University of Geneva, Geneva, Switzerland.
Swiss medical weekly
|April 5, 2024
概括
医生在医院前护理方面的经验没有影响患者在现场出院率. 然而,更有经验的医生更有可能将患者交给救护人员,并且需要更少的监督.
科学领域:
- 紧急医疗 紧急医疗
- 在医院前的护理.
- 医学教育 医学教育
背景情况:
- 临床经验显著影响患者的结果,但其在医院前环境中的作用仍未得到充分研究.
- 了解医生经验对于优化医院前干预和患者护理至关重要.
研究的目的:
- 调查医生临床经验与关键医院前护理结果之间的关联.
- 具体地检查患者在现场出院率,交给护理人员和监督需求.
主要方法:
- 从2010年至2019年,对移动医疗单位 (SMUR) 的医生进行的医院前干预的回顾性分析.
- 临床经验,以毕业以来的年数来衡量,是主要的暴露变量.
- 多级物流回归分析了包括现场出院,护理人员交接和医生监督在内的结果.
主要成果:
- 分析包括48,368名成年患者,由219名医生治疗,平均经验为5.2年.
- 医生经验与患者在现场出院率 (7.8%) 之间没有发现显著的关联.
- 增加医生经验与更高的患者移交给护理人员的比率以及减少对高级监督的需求相关.
结论:
- 医生在医院前护理方面的经验水平似乎不会影响患者在现场出院的可能性.
- 较大的临床经验与患者转移到护理人员的增加以及对监督的需求减少有关.
- 调查结果表明,经验提炼了决策,使护理人员能够在医院前医疗中进行交接和独立实践.
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